Predictive value of maternal serum β-hCG concentration in the ruptured tubal ectopic pregnancy.

Background: Measurement of serum β-hCG concentration commonly used to diagnose tubal ectopic pregnancy (EP) and follow up patients treated conservatively.

Objective: The aim of this study was to determine the predictive value of maternal serum β-hCG concentration in ruptured tubal ectopic pregnancy to help physicians identify those women who are at greatest risk.

Materials and methods: This is a cross-sectional study conducted on all women with a diagnosis of tubal ectopic pregnancy who were treated in Alzahra Hospital, in Rasht, from March 2002 to February 2011. The data was collected for each woman from medical records and included age, parity, gravidia, gestational age, primary level of serum β-hCG, rupture status, past history of pelvic inflammation disease, EP, abortion, and intrauterine contraceptive device use. Women with tubal rupture were compared to those without rupture. Statistical analysis was conducted by SPSS 19 for Windows.

Results: A total of 247 cases of tubal ectopic pregnancy were recorded during the study period. One hundred and ninety seven (79.8%) were cases with unruptured EP and 50 patients (20.2 %) were cases with ruptured EP. The mean level of β-hCG was significantly higher in patients with ruptured EP compared to patients with unruptured EP (p=0.03). Logistic regression analysis revealed that >1750 IU/ml of β-hCG levels (OR: 1.41; 95% CI: 1.18-1.68) was the significant risk factors for tubal rupture.

Conclusion: Higher β-hCG levels seem to be significant risk factors for rupture of a tubal EP.